Physical Examinations of Psychiatric Patients who Presented at the Emergency Department of a Tertiary-Care Hospital in Oman

OBJECTIVE: The objective of this study was to examine the completeness of physical assessment of patients presenting with psychiatric problems to the Emergency Department (ED). METHODS: This was to observational study based on a retrospective review of the medical records of patients who attended the ED of Sultan Qaboos University Hospital and referred to the on-duty psychiatrist for assessment over a 12 months period. All patients aged 16 years and above, who presented to the ED with a psychiatric complaint were included in the study. A data collection sheet was designed to gather each patient's demographic data such as age and gender, past psychiatric history, nature of the presenting complaints, thoroughness of physical assessment, medications prescribed by the ED doctor prior to psychiatric assessment, and whether the patient was discharged, admitted to a psychiatry or medical ward. RESULTS: A total of 202 patients met the inclusion criteria. The mean age of the patients was 34.2 years. Females represented 56% of the sample. The majority of the study group (60.4%) were patients with a documented past psychiatric history. Physical examination was conducted in the ED for 61.4% of the patients, while vital signs were recorded for 68.8% of them. Approximately, 31% of the patients required injectable psychotropic medications as tranquillizers in the ED. Patients with an isolated psychiatric complaint coupled with a documented past psychiatric history were more likely to be referred to the on-call psychiatrist without a physical examination by the ED doctors. CONCLUSION: In our institution, not all patients with psychiatric presentations had a complete physical examination by the ED doctors.